More Than 50 Long-Term Effects of COVID-19: A Systematic Review and Meta-Analysis

Abstract

Background. COVID-19, caused by SARS-CoV-2, can involve sequelae and other medical complications that last weeks to months after initial recovery, which has come to be called Long-COVID or COVID long-haulers. This systematic review and meta-analysis aims to identify studies assessing long-term effects of COVID-19 and estimates the prevalence of each symptom, sign, or laboratory parameter of patients at a post-COVID-19 stage. Methods. LitCOVID (PubMed and Medline) and Embase were searched by two independent researchers. All articles with original data for detecting long-term COVID-19 published before 1st of January 2021 and with a minimum of 100 patients were included. For effects reported in two or more studies, meta-analyses using a random-effects model were performed using the MetaXL software to estimate the pooled prevalence with 95% CI. Heterogeneity was assessed using I2 statistics. This systematic review followed Preferred Reporting Items for Systematic Reviewers and Meta-analysis (PRISMA) guidelines, although the study protocol was not registered. Results. A total of 18,251 publications were identified, of which 15 met the inclusion criteria. The prevalence of 55 long-term effects was estimated, 21 meta-analyses were performed, and 47,910 patients were included. The follow-up time ranged from 14 to 110 days post-viral infection. The age of the study participants ranged between 17 and 87 years. It was estimated that 80% (95% CI 65-92) of the patients that were infected with SARS-CoV-2 developed one or more long-term symptoms. The five most common symptoms were fatigue (58%), headache (44%), attention disorder (27%), hair loss (25%), and dyspnea (24%). All meta-analyses showed medium (n=2) to high heterogeneity (n=13). Conclusions. In order to have a better understanding, future studies need to stratify by sex, age, previous comorbidities, the severity of COVID-19 (ranging from asymptomatic to severe), and duration of each symptom. From the clinical perspective, multi-disciplinary teams are crucial to developing preventive measures, rehabilitation techniques, and clinical management strategies with whole-patient perspectives designed to address long COVID-19 care.

Post-COVID-19 Syndrome: The Persistent Symptoms at the Post-viral Stage of the Disease. A Systematic Review of the Current Data

“…Numerous research groups reported widespread persisting symptoms in COVID-19 patients for up to 6 months after SARS-CoV-2 infection (70,75,(123)(124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136)(137)(138)(139)(140)(141)(142). They also described practice on the management of post-acute COVID-19 and performed comprehensive analyses of health-related quality of life (70,75,123).…”

“…They also described practice on the management of post-acute COVID-19 and performed comprehensive analyses of health-related quality of life (70,75,123). Furthermore, numerous editorials, reviews, news articles, clinical updates, narrative interviews, and focus groups have been published to explore what it is like to live with long-term COVID-19, also trying to emphasize the putative pathophysiology, risk factors, and treatments (124)(125)(126)(127)(128)(129)(130)(131)(132)(133)(134)(135)(136)(137)(138)(139)(140)(141)(142). Two cohort studies on severe/critical COVID-19 patients reported persistent physiological impairment and decrease in quality of life in more than half of the patients at up to 6 months of follow up (77,100).…”

Langzeitpflegeeinrichtungen in der COVID-19-Pandemie

“…Unter mehr als 50 beschriebenen Post-COVID-Symptomen scheint die Fatigue das häufigste zu sein [ 21 ]. Jüngeren wird in der Regel Ruhe, Stressreduktion, keine sportlichen Aktivitäten und Entspannung empfohlen.…”

Increased risk of chronic fatigue and hair loss following COVID-19 in individuals with hypohidrotic ectodermal dysplasia

“…There is an increasing number of individuals who suffer from postacute COVID-19, a syndrome characterized by persistent symptoms and/or delayed or long-term complications beyond 4 weeks from the onset of symptoms [17,18], including anosmia, muscular weakness, chronic fatigue, cognitive and sleep disturbances, chest pain, palpitations, and hair loss. A systematic meta-analysis of cohort studies [19] revealed prolonged effects after acute COVID-19 in 80% of the study population aged 17-87 years. Persistent respiratory symptoms, rather independent of the severity of initial lung involvement [20], have often been recorded and follow-up of large groups of patients indicated breathlessness to be one of the most frequent postinfectious health issues [21,22].…”